Dear Sheila,

I am sorry that the HB is so low, i am sure you must be feeling with concerned especially in regards to starting a new med.

The difficulty with anemia is that RA can cause it, MTX can also cause it as can other meds. The best thing to do (before gastro and tubes) is to check the iron levels more in depth.

I am also coeliac and one of the main symptoms (but which can also be hidden and therefore decepetive) is severe anemia. I am guessing the Gastro would bring this up anyway.

A good way of getting iron into the system is liver and other organs. Failing that nettles are a great iron inducing herb. So is dandelion.

The gentler form of iron may be the only thing that increases the level to at least 10. I do take iron everyday with orange juice..and try and keep it up with herbs and liver..

Love,

Amanda

Hi Sheila,

I also have anaemia as a result of the RA. My levels dropped to around 9 about two years ago and haven't gone up since. I take iron supplements each day.

Initially, when the iron levels dropped, I was sent for an endoscopy (tube down the throat) and nothing was found so I then had two colonoscopies (tube from the other end ) where they discovered inflammation of the colon and bowels. I was also experiencing other bowel related problems and was passing blood. After many more appointments and discussions, it was decided that the inflammation was RA and the blood loss was contributing to the anaemia. (Sorry for all the graphic details!)

I think anaemia is one of the little joys of RA but can be helped with supplements, monitored and pretty much left providing it isn't masking another underlying condition. I suspect the docs will want to rule out other causes of anaemia and then play it by ear a little.

Regarding the endoscopy, I wouldn't think you would be at increased risk of infection having it before your Rituximab. Maybe if you are concerned, they can postpone it until afterwards.

Hope it all goes well!

Joanna

PS Amanda ... thanks for all the tips on sources of iron. I used to love liver as a child but never eat it now because I don't know how to cook it properly.

Hi Joanna and Amanda,
Many thanks for the advice and the pate idea, hadn't thought of that and I love pate. Will definitely make some soon especially after trying to open the latest pot of iron tablets with a vice, wrist supports, mole wrench and a good deal of sweat! (partner has gone out for the evening - probably because I told him he needs to go nettle hunting tomorrow.)
Spoke to GP yesterday and he's happy for me to put endoscopy off for a month.
Joanna, sorry to hear you had to have so many procedures to check the anemia, no it wasn't too graphic, I'd rather know what might be to come, thanks for sharing it with me.
Love to you both
Sheila